La demencia con cuerpos de Lewy y la demencia de la enfermedad de Parkinson son reconocidas ahora como dos entidades distintas que forman parte del espectro de una misma enfermedad: Enfermedad por cuerpos de Lewy. Ambas, se caracterizan patológicamente por el depósito de la proteína sinucleína, y clínicamente por una mixtura variable de características cognitivas, neuropsiquiátricas y extra-piramidales. Es importante diferenciarlas de la enfermedad de Alzheimer y de otras demencias degenerativas, y en ello es útil las guías prácticas publicadas por la Academia Americana de Neurología y el Consorcio para el diagnóstico de Demencia con cuerpos de Lewy. No obstante, las respuestas clínicas son impredecibles, los inhibidores de colinesterasas han demostrado brindar beneficios cognitivos, funcionales y conductuales; pero sobre todo que no afectan las características motoras del parkinsonismo. Teniendo claro, que el manejo clínico actual de ambas entidades es meramente sintomático, los principales retos en el futuro son mejorar el conocimiento de la fisiopatología, determinar la expresión fenotípica clínica y desarrollar terapias que modifiquen el curso de la enfermedad.
English version
SUMMARY:
The dementia for Lewys’ bodies and dementia for Parkinson’s disease are know how two different entities that forms part of the same disease: Disease for Lewys’ bodies. They both are characterised for the same stored of synuclein protein, and clinically for a mixed variable of cognitive, neuropsychiatry and extrapyramidal characteristics. It is very important differentiate between Alzheimer’s and another degenerative disease. For this reason, the guides of American Academy of Neurology and the Holding for Diagnosis of Dementia with. Lewys’ bodies are very important in diagnosis and treatment. However; the clinics responses are indispensables, the cholinesterases inhibitors have demonstrated give cognitive, functional and behavioural improves; but overall not affecting the motor characteristics of Parkinsonism. Having clear, that clinic management of both entities are symptomatic, the principal challenges in the future are improve the knowledge of physiopathology, determine the clinic phenotypical expression and development therapies that modify the course of disease.
English version
SUMMARY:
The dementia for Lewys’ bodies and dementia for Parkinson’s disease are know how two different entities that forms part of the same disease: Disease for Lewys’ bodies. They both are characterised for the same stored of synuclein protein, and clinically for a mixed variable of cognitive, neuropsychiatry and extrapyramidal characteristics. It is very important differentiate between Alzheimer’s and another degenerative disease. For this reason, the guides of American Academy of Neurology and the Holding for Diagnosis of Dementia with. Lewys’ bodies are very important in diagnosis and treatment. However; the clinics responses are indispensables, the cholinesterases inhibitors have demonstrated give cognitive, functional and behavioural improves; but overall not affecting the motor characteristics of Parkinsonism. Having clear, that clinic management of both entities are symptomatic, the principal challenges in the future are improve the knowledge of physiopathology, determine the clinic phenotypical expression and development therapies that modify the course of disease.
Publicación:
Revista de la Sociedad Peruana de Neurología
2007
No hay comentarios:
Publicar un comentario